Case studies
Each piece below takes one published clinical trial or physiological model, replicates it inside the composed body, and shows what the extension into a counterfactual or sub-population looks like. The full methodology, equations, and paper anchors are in each piece.
- Mechanistic Modelling
Repurposed antiparasitics in oncology: what the mechanism predicts
Ivermectin and mebendazole both have anti-cancer mechanisms that are active at concentrations reachable with oral dosing. The composed body model predicts a real but modest combined effect at 90 days — far below the headline numbers in current observational reports. The trial that would distinguish drug effect from concomitant therapy has not been run.Ivermectin and mebendazole both have anti-cancer mechanisms that are active at concentrations reachable with oral dosing. The composed body model predicts a real but modest combined effect at 90 days — far below the headline numbers in current observational reports. The trial that would distinguish drug effect from concomitant therapy has not been run.
oncologydrug-repurposingantiparasiticsivermectinmebendazoleRead the full case study → - Mechanistic Modelling
The cascade that decouples from the virus
Hantavirus cardiopulmonary syndrome — organ-by-organ mechanism that turns each drug's effective window into a structural property of the diseaseHantavirus does not kill cells directly. It kills by triggering a cytokine cascade that, once committed, propagates organ by organ — lung capillary leak, vascular shock, marrow suppression, lactic acidosis — independently of the virus that started it. The cascade is what makes the timing window structural, not pharmacological.
hantavirusHPScytokine-cascadeendotheliumcapillary-leakRead the full case study → - Drug Safety
The metastasis question every anabolic bone drug avoids
Bisphosphonates and denosumab have been studied in cancer with bone metastases. Teriparatide and romosozumab have not. The mechanism case for asking the question lives in the Lemaire-Pivonka coupled bone model.Bisphosphonates and denosumab reduce skeletal-related events in cancer with bone metastases. The anabolic bone drugs — teriparatide, romosozumab — have not been studied in patients with cancer at all. The same physiology that builds bone could plausibly feed an occult metastasis. A coupled Lemaire-Pivonka model lets us ask the question the trials did not.
bonemetastasisteriparatideromosozumabdenosumabRead the full case study → - Mechanism Attribution
Attributing the GLP-1 cardiovascular signal to its underlying mechanisms
SELECT reduced MACE by 20%. The model decomposes that signal into weight-loss-mediated, glycaemia-mediated, and direct cardiac channels — with consequences for every next-generation molecule whose profile differs from semaglutide's.SELECT showed semaglutide reduced major adverse cardiovascular events by 20% in non-diabetic patients with established cardiovascular disease. Three plausible mechanisms could explain that signal — direct cardiac receptor effects, glucose-mediated, or downstream of weight loss. A coupled body model says the third channel carries most of the effect — which has direct consequences for the next-generation GLP-1-without-weight-loss molecules now in development.
GLP-1semaglutidetirzepatideSELECTLEADERRead the full case study → - Drug Safety
Separating pseudoatrophy from neurotoxicity
Anti-amyloid Alzheimer drugs — 30-month projection beyond the trial horizonLecanemab and donanemab reduce cognitive decline ~25–33% over 18 months. They also shrink the brain — by about half a percent of whole-brain volume in the same window. The pseudoatrophy and the real-neurotoxicity hypotheses make identical 18-month predictions. The data needed to distinguish them does not exist yet.
alzheimerlecanemabdonanemabanti-amyloidpseudoatrophyRead the full case study → - Trial Replication
Quantifying the timing cliff PALM could not surface
Ebola — 22-state coupled model calibrated against all six PALM treatment armsThe PALM trial established that mAb114 and REGN-EB3 reduce mortality in Ebola. It did not establish how outcomes depend on when treatment starts. A coupled 22-state model, calibrated against all six PALM arms, says the answer is steeper than the field assumes — and the implication is logistical, not pharmacological.
ebolaPALM-trialmAb114REGN-EB3timing-windowRead the full case study → - Methodology
When a category error matters
Patient trajectory foundation model versus mechanistic digital twinWhy a generative transformer over electronic health records cannot answer the counterfactual question every clinician actually wants to ask — and what the engineering definition of digital twin requires instead.
digital-twincounterfactualODEtransformerEHRRead the full case study →